Individual
RILEY BOSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4520 CENTERVILLE RD, SAINT PAUL, MN 55127-3602
(651) 426-4799
Mailing address
4520 CENTERVILLE RD, SAINT PAUL, MN 55127-3602
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12923
MN
Other
Enumeration date
06/02/2011
Last updated
06/02/2011
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